Fixation of intra-articular fractures of the distal radius using intramedullary nailing: a randomized trial versus palmar locking plates

Gradl, Gertraud; Falk, Steffi; Mittlmeier, Thomas; Wendt, Matthias; Mielsch, Nadja; Gradl, Georg

doi:10.1016/s0020-1383(16)30850-6

Cited by 21 publications

(19 citation statements)

References 20 publications

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“…Consistent with our findings, intramedullary nail fixation with the Targon DR nail was reported to be associated with shorter median operative time than with volar plate fixation in treatment of distal radius fractures, despite higher fluoroscopy times with Targon DR nails due to less direct exposure and indirect reduction technique, necessitating frequent fluoroscopic controls [ 39 , 40 ].…”

Section: Discussionsupporting

confidence: 86%

“…In another study, equivalent radiographic and functional outcomes of volar locking plate fixation were also shown with other intramedullary nailing implants (Targon DR nail) among patients with distal radius fractures of AO 23 C2.1 type at 8 weeks, while better ROM in extension and better restoration of volar tilt and ulnar variance were shown in the volar plate group at 2 years after the operation, with similar reduction maintenance and complications rates in both groups [ 39 ].…”

Section: Discussionmentioning

confidence: 89%

“…However, comparison of ulnar variance and volar tilt outcome in intramedullary nailing (Targon DR) vs. volar plate fixation of distal radius fractures revealed inconsistent findings with better restoration of both parameters with nail fixation in one study [ 39 ] and similar outcome in another study [ 40 ], while both studies indicated no significant difference between treatment groups in terms of loss of reduction [ 39 , 40 ].…”

Section: Discussionmentioning

confidence: 99%

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Use of Volar Locking Plate Versus Intramedullary Nailing for Fixation of Distal Radius Fractures: A Retrospective Analysis of Clinical and Radiographic Outcomes

Çalbıyık

İpek

2018

Med Sci Monit

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BackgroundThe objective of this study was to evaluate clinical and radiographic outcomes of volar plate versus intramedullary nailing for fixation of distal radius fractures.Material/MethodsThis retrospective study included 64 patients with extra-articular and simple intra-articular fractures of the distal radius who underwent intramedullary fixation using volar locking plate (n=35, mean age 47.3±16.4 years, 82.9% female) or intramedullary nailing (n=29, mean age 51.3±10.1 years, 58.6% female). Outcome measures were range of motion (ROM); visual analog scale (VAS); Disabilities of the Arm, Shoulder, and Hand (DASH) score; Gartland-Werley score; Stewart score; and radiographic findings.ResultsTime to fracture union was 5.5±1.2 and 5.2±0.6 weeks after volar plate fixation and intramedullary nailing, respectively (p>0.05). Compared to volar plate fixation, intramedullary nailing provided better restoration of volar tilt (6.9±6.3° vs. 9.4±1.6°, p=0.004) and wrist flexion (74.3±15.1° vs. 67.9±13.1°, p=0.003). However, volar plate fixation was significantly better in restoration of supination (85.0±8.3° vs. 81.9±5.1°, p=0.001) and radio-ulnar variance (0.7±0.8 mm vs. 1.1±0.9 mm, p=0.05), DASH score (9.2± 9.0 vs. 15.0 ±3.3, p=0.035), and Gartland-Werley score (1.8±0.9 vs. 4.9±5.4, p=0.004). Volar plate and intramedullary nailing groups were comparable with respect to Stewart score (1.5±0.7 and 1.6±1.3, p>0.05) and complication rates (34.3% vs. 37.9%, p>0.05).ConclusionsBoth volar plate fixation and intramedullary nail fixation provide good clinical and radiographic outcomes for primarily extra-articular or simple intra-articular distal radius fractures. As intramedullary nailing provides better restoration of volar tilt and wrist flexion, volar plate fixation provides better restoration of radio-ulnar variance and wrist supination.

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Section: Discussionsupporting

confidence: 86%

Section: Discussionmentioning

confidence: 89%

Section: Discussionmentioning

confidence: 99%

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Use of Volar Locking Plate Versus Intramedullary Nailing for Fixation of Distal Radius Fractures: A Retrospective Analysis of Clinical and Radiographic Outcomes

Çalbıyık

İpek

2018

Med Sci Monit

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“…Conversely, other authors have recommended articular reconstruction and carpal alignment restoration (Ng and McQueen, 2011). However, studies of intra-articular fractures have usually focused on young patients (Gradl et al, 2016;Sharma et al, 2014;Toon et al, 2017). Two studies have focused on intra-articular fractures in elderly patients and compared volar plating with external fixation or non-operative treatment.…”

Section: Introductionmentioning

confidence: 99%

Intra-articular distal radius fractures in elderly patients: a randomized prospective study of casting versus volar plating

Martinez-Mendez

Lizaur-Utrilla

de-Juan-Herrero

2017

J Hand Surg Eur Vol

102

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“…Several studies comparing intramedullary nail with a locking plate in the treatment of distal radius fractures are currently available in the literature [28, 30, 34, 35]. All studies concluded that both devices achieved equally good functional outcomes; while a systemic review indicated that intramedullary nails facilitated favorable functional results with radiological and clinical parameters nearly equivalent to locking plates [36].…”

Section: Discussionmentioning

confidence: 99%

Intramedullary nailing and plating osteosynthesis in the correction of post-traumatic deformity in late-diagnosed distal radius fractures: a retrospective comparison study

Chen

Cheng

Weng

et al. 2019

BMC Musculoskelet Disord

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Background Various surgical modalities are available for correction of deformity in late-diagnosed distal radius fractures. This study compared surgical outcomes between intramedullary nailing and plating osteosynthesis in open-wedge osteotomy. Methods We retrospectively reviewed 47 unilateral distal radius fractures that underwent open-wedge osteotomy at more than 4 weeks after injury between 2006 and 2011. A locally resected exuberant callus was used as the bone graft. Two types of fixation were used: intramedullary nail in 22 patients (group A) and locking plate in 25 patients (group B). Radiographic analysis including radial height, radial inclination, and volar tilt were performed preoperatively and 2-year postoperatively. The Modified Mayo Wrist Score (MMWS) was used for functional evaluation and a 10-point visual analog scale (VAS) for residual pain assessment. Patient satisfaction was self-reported as a 5-point scale. Radiographic data, functional outcomes, and surgical complications were compared between the two groups. Results All fractures achieved bone union without major complications. The MMWS averaged 84.8 ± 9.7 in group A and 85.2 ± 8.4 in group B, without significant differences ( p = 0.436). Instead, significant differences were found in mean wrist flexion (73.6 ± 7.9 vs. 69.6 ± 7.8 degrees; p = 0.042), patient satisfaction (3.6 ± 1.1 vs. 2.9 ± 1.2; p = 0.034), postoperative radial height (11.6 ± 2.6 vs. 10.2 ± 3 mm; p = 0.039) and inclination (20.8 ± 2.8 vs. 17.7 ± 4.1 degrees; p = 0.004), and implant-related complications (9% vs. 36%; p = 0.03). There were no significant differences in other assessment items including postoperative grip strength, pain scale, supination/pronation/extension, volar tilt, correction angles of all three parameters, and general complication rate. Four patients in group A (18%) and 2 in group B (8%) experienced postoperative paresthesia of the surgical hand; no significant difference was noted. All except one patient in group B had full recovery of neurological symptoms. Conclusions Open-wedge osteotomy with either an intramedullary nail or locking plate fixation yielded encouraging radiographic and functional outcomes. Intramedullary nail fixation may facilitate restoration of radial height and inclination with better wrist flexion, less implant-related complications, and greater patient satisfaction.

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Fixation of intra-articular fractures of the distal radius using intramedullary nailing: a randomized trial versus palmar locking plates

Cited by 21 publications

References 20 publications

Use of Volar Locking Plate Versus Intramedullary Nailing for Fixation of Distal Radius Fractures: A Retrospective Analysis of Clinical and Radiographic Outcomes

Use of Volar Locking Plate Versus Intramedullary Nailing for Fixation of Distal Radius Fractures: A Retrospective Analysis of Clinical and Radiographic Outcomes

Intra-articular distal radius fractures in elderly patients: a randomized prospective study of casting versus volar plating

Intramedullary nailing and plating osteosynthesis in the correction of post-traumatic deformity in late-diagnosed distal radius fractures: a retrospective comparison study

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